Wednesday, July 27, 2011

Pharmacies becoming scarce in rural Kansas counties

SCOTT CITY — Jena Brunswig understands how important it is for her and her husband, Jonathan, to keep the doors of their pharmacies in Lakin, Leoti and Scott City open.

Their Health Mart franchises are the only pharmacies in Kearny, Wichita and Scott counties, respectively. If they were to close, customers — many of them elderly — would have to drive 45 minutes to an hour to have their prescriptions filled and, of course, drive the same distance home.

Six Kansas counties are without a pharmacy, while 30 counties have only one.

"We originally opened a pharmacy in the Wichita County Health Center in Leoti about 15 years ago," Brunswig, who has a doctorate degree in pharmacy from The University of Kansas, said.

Thirteen years ago, the couple opened J&J Pharmacy in the Kearny County Health Center, and in 2003 they purchased the Scott City business.

Her husband, who also has a doctorate degree in pharmacy from KU, serves as a consultant for rural hospitals and nursing homes in Kearny, Finney, Lane, Scott and Wichita counties.

Brunswig said their pharmacies employ 20 to 25 full-time workers and about 20 to 25 part-time employees during the summer and holiday season.

"With the declining population, it's difficult to have enough people to run a business," she said.

Even more difficult is finding pharmacists who want to work and live in small western Kansas towns. So, the Brunswigs rely on "growing our own" through the KU School of Pharmacy curriculum that places students in communities for a one-month rotation. The curriculum allows community pharmacists to mentor students as they gain real-world experience.

"All the pharmacists we've hired have grown up here," she said.

Brunswig said she and her husband recently hired KU pharmacy students from Scott City and Leoti who wanted to return to their hometowns to begin their careers.

"They'll typically stay five years and then move on, although some marry and stay here," she said. "The KU perceptorship has increased our ability to find staff."

Abby Amick, director of Wabaunsee County Economic Development, said that county has been without a pharmacy since 1988, when its owner retired.

"When I started working here, it was one of my biggest concerns," Amick said.

Talks about establishing a satellite office through a pharmacy in a neighboring county was aborted when it became apparent it would be too costly to staff the pharmacy and pay overhead, she said.

"It's all the regulations that caused people not to be interested," she said, explaining how the satellite office would be required to have a full-time pharmacist to dispense and monitor the medications.

Amick said Alma residents can drive 16 miles to Wamego to pick up medications, while Alta Vista residents can travel to Council Grove, about 15 miles away, to fill prescriptions. A Rossville pharmacy makes deliveries to the Lake Wabaunsee and Eskridge areas, and a Topeka pharmacy also delivers to Lake Wabaunsee.

In addition, several area pharmacies offer mail-order services.

Brunswig said mail-order pharmacy services are a growing threat to brick-and-mortar pharmacies because they can provide medications more cheaply and be delivered to a person's mailbox.

"Schools, hospitals and the county have gone to mail-order prescriptions," she said. "It's cheaper for them to provide health insurance if they have this mail-order rider."

However, Brunswig said, mail-order pharmacies can't provide medications the day a person becomes ill or runs out of medication.

"Waiting three days for an antibiotic from mail order is not quality care," she said.

Consequently, the Brunswigs' pharmacies fill and deliver prescriptions to elderly residents who live in town and sometimes to rural areas.

"I hope that the population sustains our business, and the health insurance legislation will not inhibit our health care service," she said. "There are a lot of unknowns, and so many things are out of our control. The future of hospitals, clinics and pharmacies is unknown."